Centene, Lacking Doctors, Forced to Halt Sales in One State

(Bloomberg) -- Centene Corp. halted sales of health insurance plans in Washington State after regulators found the company failed to cover enough doctors and other care providers, threatening to leave some counties with no Obamacare insurance options.

Washington’s Insurance Commissioner told Coordinated Care Corp., a Centene unit, to stop selling 2018 plans in a Dec. 12 order. The regulator said it intervened after receiving about 100 consumer complaints about a lack of doctors in Centene’s network, and that the insurer failed to fix the problems.

The halt is a setback for Centene, which has been rapidly expanding in Obamacare, relying on a strategy of offering consumers a limited choice of doctors and hospitals, in exchange for a lower up-front premium. Bloomberg found earlier this year that some Centene customers faced difficulties visiting their preferred hospitals and doctors in the insurer’s Affordable Care Act plans. In their Dec. 12 order, Washington regulators said the problem was systemic.

“The Company failed to provide an adequate network of providers, failed to monitor its network of providers, failed to report its inadequate network to the Insurance Commissioner, failed to timely file an alternative access delivery request to ensure that consumers received access to healthcare providers,” the regulator said in the order.

Centene’s plans remained available on the state’s insurance-shopping website, but it wasn’t clear if the enrollments would be honored, and a spokesman for the exchange said he couldn’t immediately provide more information. Centene sent a letter to brokers on Dec. 14 telling them that Coordinated Care would stop accepting applications for coverage as of Dec. 13.

In Washington, Friday is the last day to enroll in coverage that starts on Jan. 1, but the final deadline for 2018 plans that start later in the year is Jan. 15.

“We’re going to enroll people as long as the exchange stays open,” said Matt McColm, a Washington State insurance broker. “We’re going to tell our customers straight up, these plans might not be honored. If they’re not honored, we’ll have to figure something out.”

McColm, along with his wife Suzie, runs an insurance agency in Wenatchee, Washington. Centene is the only option on the ACA exchange in the area.

“They threw us this monkey wrench,” Suzie McColm said.

A Centene representative had no immediate comment. In Washington, the company received a one-star rating, out of five, on a state ranking of customer experience.

--With assistance from Hannah Recht and Bryan Gruley

To contact the reporter on this story: Zachary Tracer in New York at ztracer1@bloomberg.net.

To contact the editors responsible for this story: Drew Armstrong at darmstrong17@bloomberg.net, Cecile Daurat

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